Cognitive measures are usually stable 5 years after an epilepsy diagnosis

People with epilepsy often worry about whether their thinking and memory are going to get worse over time. When they do occur, problems with thinking and memory (cognition) can result from several factors: frequent seizures, the postictal (after-seizure) state, effects of underlying injuries that may have caused seizures, impairment by seizure medications, or causes unrelated to epilepsy, such as aging. Now a study has been published by Taylor and Baker in Epilepsy & Behavior June 15, 2010 that is generally reassuring. A comprehensive test battery was administered to 50 people with newly diagnosed epilepsy right after diagnosis, before treatment with antiepileptic drugs, and again approximately 5 years later.For most tests, differences were small. Among 16 tests, improvement was seen in three, decline of 0-5% in six, decline of 5-10% in two and decline of 10-17% in five. Overall, 38% of subjects experienced cognitive decline. The message is that cognitive function worsens in some people with epilepsy, but at 5 years after diagnosis, not in the majority, and when it occurs, decline usually is small. Although not a focus of this article, it is important to recognize cognitive decline and attempt to diagnose the cause and treat it when it does occur. Sometimes, an adjustment of antiepileptic medications can lead to a great improvement in cognitive problems. Do not change medicines on your own, but discuss any thinking or memory side effects with your doctor.